Nursing Elites

1. The nurse is assisting with the admission of a young adult female Korean exchange student with acute abdominal pain. Although the client has been able to easily answer questions, when asked about sexual activity, she looks away. What action should the nurse take?

• A. Omit the section of the assessment form
• B. Ask her if she would like an interpreter to help her understand the question
• C. Reword the question to make it more culturally sensitive
• D. Observe the client's response when asked a different question

Correct answer: D

Rationale: Observing the client's response to another question is the most appropriate action in this scenario. By doing so, the nurse can assess whether the client's discomfort is due to cultural sensitivity or a misunderstanding. This approach allows the nurse to proceed with sensitivity and respect, ensuring effective communication. Option A is incorrect because omitting the section of the assessment form may result in missing crucial information relevant to the client's condition. Option B jumps to assumptions about a language barrier without confirming it first. Option C focuses on rewording the question without addressing the underlying issue causing the client's discomfort, which may not necessarily be due to a lack of understanding.

2. What is the most common cause of acute pancreatitis?

• A. Gallstones
• B. Alcohol abuse
• C. Hypertriglyceridemia
• D. Infection

Correct answer: A

Rationale: The correct answer is A: Gallstones. Gallstones are the most common cause of acute pancreatitis as they obstruct the pancreatic duct, leading to inflammation. While alcohol abuse (Choice B) can also cause pancreatitis, gallstones are more prevalent. Hypertriglyceridemia (Choice C) is a less common cause of acute pancreatitis compared to gallstones. Infection (Choice D) is not a primary cause of acute pancreatitis; gallstones are the leading etiology.

3. An adult client is undergoing weekly external radiation treatments for breast cancer. Upon arrival at the outpatient clinic for a scheduled treatment, the client reports increasing fatigue to the nurse who is taking the client's vital signs. What action should the nurse implement?

• A. Notify the healthcare provider or charge nurse immediately
• B. Offer to reschedule the treatment for the following week
• C. Plan to monitor the client's vital signs every 30 minutes
• D. Reinforce the need for extra rest periods and plenty of sleep

Correct answer: D

Rationale: Fatigue is a common side effect of radiation therapy. In this scenario, the appropriate action for the nurse to take is to reinforce the importance of rest and adequate sleep. It is crucial to address the client's increasing fatigue by promoting self-care strategies such as additional rest periods and ensuring plenty of sleep. Rescheduling the treatment is not necessary for fatigue, and vital sign monitoring every 30 minutes may not directly address the client's reported symptom. Notifying the healthcare provider or charge nurse immediately is not the first-line intervention for increasing fatigue, as this symptom can be managed through education and self-care recommendations.

4. What is the primary function of hemoglobin in red blood cells?

• A. To transport oxygen from the lungs to body tissues
• B. To protect the body from infections
• C. To help in blood clotting
• D. To regulate body temperature

Correct answer: A

Rationale: The primary function of hemoglobin in red blood cells is to transport oxygen from the lungs to body tissues and return carbon dioxide from the tissues to the lungs. Hemoglobin binds to oxygen in the lungs and releases it in the body's tissues. Choice B is incorrect because hemoglobin is not involved in protecting the body from infections. Choice C is incorrect because blood clotting is mainly facilitated by platelets and clotting factors, not hemoglobin. Choice D is incorrect because the regulation of body temperature is mainly controlled by processes like sweating and shivering, not by hemoglobin.

5. The PN administered darbepoetin alfa to a client with chronic kidney disease (CKD). Which serum laboratory value should the PN monitor to assess the effectiveness of this drug?

• A. Calcium
• B. Phosphorus
• C. Hemoglobin
• D. White blood cell count

Correct answer: C

Rationale: Darbepoetin alfa is used to stimulate red blood cell production in clients with CKD. Monitoring hemoglobin levels is essential to assess the effectiveness of the treatment and to adjust the dosage to avoid complications such as hypertension or thrombosis. Monitoring calcium (Choice A), phosphorus (Choice B), or white blood cell count (Choice D) is not directly related to the effectiveness of darbepoetin alfa in treating anemia associated with CKD.

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